IVF #2, Negative

Just got the call: officially not pregnant. Again. I'm so angry I don't know what to do. I had such hope for this cycle....everything went so well, the embryos were so healthy and strong. I really thought this was going to be our time, after almost 6 years I really thought we would finally be parents. I just do not understand why my body keeps failing at something that is so natural and easy for so many others.

IVF #2, Transfer

Our transfer was on Sunday, and it went very well. Dr. G called me on Sunday morning to give me the report on the health of our embryos: my clinic uses a grading system where Grade 1 - AA is the highest grade. Dr. G explained that grade 1-AA embryos are very, very rare. He told me that we had one grade 1 - AB blastocyst, and one grade 1 -BB blastocyst that were both looking spectacular, AND 2 more blastocyst stage embryos that were not far behind and looked really, really good, AND 2 more embryos that were ALMOST at the blastocyst stage and still thriving.

We agreed that since I'm 39, and this is probably our last hurrah, we would transfer 3 blasts instead of just 2. Dr. G said he felt in my situation the danger of becoming pregnant with triplets was only about 5%, and the chance of twins is about 30%.

So, we transferred the two grade 1 blasts and one of the other blastocysts. The transfer was much more comfortable this time around because I didn't drink so much water! It was so very painful for me the first time we did IVF, so I decided not to drink as much water as they recommended this time around, and it worked out much better. I've always thought I had a small bladder, and apparently I'm right, as it certainly didn't take 32 oz. to fill mine up. I drank maybe 16 oz of water before the transfer, and the doctor said my bladder was "perfectly full" and really helped to visualize everything via ultrasound.

The other new thing this time around is that the embryologist came back into the room while I was "resting" for the required 5 minutes afterward, and handed us a framed photo of our beautiful embryos. This of course, made me cry even harder than I already was. I have done nothing but stare at the picture since we got home on Sunday. I think it must help to sort of visualize them in there, making a happy home....

I just this minute got a call from my nurse, informing me that as of today, we have TWO frozen embryos!! I'm so surprised, and so excited! The doctor told us on Sunday that they would watch the remaining three of our embryos that we didn't transfer, for the next two days in the lab, to see if they would continue thriving, and that if they were robust enough by day 7, they would freeze them. But, she said it was only a 50/50 chance that they would make it. So, I'm so pleasantly surprised to learn that TWO of them made it!! I'm so proud of them!!

Anyway, I'm only in the very beginning of the two-week-wait, and I already feel like time is just draaaagggginng on. The 2ww always feels like torture to me. Nothing left to do but pray, each and every day.

IVF #2, Day 3 after retrieval

Working from home today, and just got off of a conference call and received an update from much beloved Dr. G. via voicemail: "K, just wanted to call and see how you're feeling, and to let you know that your embryos are looking WONDERFUL. Of the 11, all are still thriving, and 10 of them are considered grade 1 (1 being the best grade), and the other one is not far behind. I'll call tomorrow to check on you and give you another update. Things are definitely looking good this time!"

In our first IVF, we only had one embryo that was considered grade 1. So, I know that having many high-grade embryos is not by any means a guarantee of success, but any way you look at it, this is good news and a reason to smile all day long today.

Frighteningly, hope is alive and well at this point, although something inside of me, even still, is bracing for the inevitable crash.

2010, and IVF #2

On January 15, 2010, we found out that our 4th IUI had failed, and after consulting with Dr. G, we decided to do ONE more round of IVF. Financially, it only makes sense that this is our last IVF attempt. It is SO expensive, and we're getting excited about pursuing adoption, but we can't afford to do both at the same time! We decided that if this last round of IVF doesn't work, we will close the door on this phase of our lives. For 5 years we've been chasing the dream of becoming parents through biological means, and it just feels like we've done everything we possibly could have done, to that end. It feels like the right time to bring the physical treatment phase to closure. Although I know I will be devastated if this doesn't work.....there's a part of me that feels good about being able to say - never again - to the appointments, the injections, the rearrangement of work schedules and vacations and holidays to accommodate treatment, to the up and down roller coaster of wondering each time if we'll get lucky, etc. I know that adoption is going to present MANY challenges, but at least we can put the past 5 year's worth of treatment oriented challenges behind us, finally.

I thought it would be interesting to chronicle the last 5 years in a succinct list:

October 2004 - Married! Me -33, R - 35

October 2004 - May 2006 - TTC the old fashioned way. Me - 33 to 35, R - 35 to 36

July 2006 - September 2006 - Clomid/timed intercourse cycles - No response from ovaries. Me - 35, R - 37

January 2007 - April 2007 - IUI#1 - BFN (longest stim cycle on record at Fertility Clinic #1 - 65 consecutive days of FSH injections) Me - 36, R - 37

July 2007 - August 2007 - IVF#1 - BFN (Moved to Fertility Clinic #2 and much beloved Dr. G. Best decision ever!) Me - 36, R - 38

September 2007 - May 2009 - BREAK (Gall bladder surgery, major house repairs - impact on budget, lost almost 100 pounds...) Me - 36 to 38, R - 38 to 39

July 2009 - IUI#2 - BFN. Me - 38, R - 40

August 2009 - IUI#3 - BFP! Me - 38, R - 40

September 2009 - Miscarriage (Non-doubling HGG numbers in early pregnancy, presumed ectopic, given methotrexate injections to induce miscarriage) Me - 38, R - 40

November 2009 - IUI#4 - BFN. Me - 39, R - 40

January 2009 - IUI#5 - BFN. Me - 39, R - 40

March 2010 - IVF#2 - ????????? Me - 39, R - 40

Wow, that all looks very tidy and speedy, laid out like that in a list. But it feels like an absolute LIFETIME since those first Clomid cycles at my OB/GYN's office. Oh, how naive I was back then!! And so very impatient!

So, here we are at the tail end of IVF #2. 14 eggs retrieved on Tuesday. Of the 14, 11 of them were mature and all fertilized. As of today, Day #2 after retrieval, all 11 embryos still thriving. Hurray!

We'll wait now to see how may make it blastocyst stage - Day 5 transfer is scheduled for this weekend on Sunday, and after that, it's all over but the cryin'.

All we can do now is pray!

I have been thinking for quite a while that I was finished with this blog. So it was surprising to me tonight when I felt an urge to document some things here. But, I have come back here on several occasions when I was reflecting on our infertility history and couldn't remember the exact sequence of events that led up to a particular milestone, or when I couldn't remember the date or time frame of an event. So, I thought that I'd probably regret it if I didn't get some of the details of our latest attempt chronicled here, if only so that I can read back through it at some much later date, and get whatever I need from it....

So - we started treatment again in July, and we decided to start from the beginning again. Since I have lost a considerable amount of weight, our doctor agreed that my body might react differently and with less medication than during our previous attempts, and that it made sense to perhaps start with the lesser expensive IUI treatments before advancing on to IVF again. So, I took 150 mg of Clomid along with a few low doses of injectable FSH medications (which were graciously donated to us by dear friends who are now 7 months pregnant with the fruits of their latest cycle) and we did an IUI procedure (our 2nd ever) on July 10. On July 24 we found out that it was unsuccessful. We started another cycle immediately, and had IUI procedure #3 on Aug 10. Here's what happened after that:

Saturday, Aug 22 - Unlike all previous attempts, this time I was nonchalant, completely sure that the IUI hadn't worked, and I did not pee-on-a-stick each and every morning for the last week of the 2 week window. I had been planning to only pee on ONE stick the morning of the beta, just because I couldn't deal with the suspense of having blood drawn and waiting for 6 hours for someone to call me to tell me my fate. But, on Sat afternoon, I went into the bathroom to pee and my last remaining pregnancy test was sticking out of a basket in my bathroom and it caught my eye, and I thought - well, what the hell, I'll just take this ONE test and then I won't have anymore in the house to tempt me, and I'll buy just one more on Monday night to take on Tuesday morning before the beta. So I peed on it, and immediately two lines came up, and reflexively, I almost threw it in the trash as I have countless other times before, thinking that it was negative, as usual. But at the last second, with the stick poised over the trash can, my heart leaped into my throat, and I thought - WAIT a minute. Two lines? Doesn't that mean something good? But, you know, on some of them you need a plus sign, and I couldn't really remember what brand of test I had taken, so I snatched up the instruction sheet, which I had thankfully saved, and tried to make sense of what I was seeing. My heart was pounding, pounding, pounding and the more I looked at the two lines the more I couldn't believe it. I raced down stairs and threw the test onto R's desk and asked him to read and tell me what it meant. He looked at it, and then he looked at me, and we stared at each other and I cried and we held each other for a few minutes, which was sheer joy, sheer elation, thank you GOD for this moment......And then I grabbed my keys and raced to the grocery store where I bought not one but 8 more tests. Because I couldn't believe it was true. I needed more reassurance. What if the one test I used was faulty? What if it was defective, had been in the humid bathroom too long, or I dropped it and broke it before I used it or what if it just LIED to me? I had to be sure, so I came home and drank 2 bottles of water and paced around until I could pee again. Then I peed on 4 sticks, all different brands, and every one of them came up immediately and strongly positive. No pussy-footing around, right away, clear as a bell. No squinting and holding the test up to the light, If you hold it this way it KIND of looks like a second line, right there? No, none of that. Straightaway positive as they could be.

The rest of Saturday, Sunday, Monday, Tuesday, Wednesday and Thursday morning passed in a joy filled haze. On Tuesday morning I went in for my first beta. I wasn't the slightest bit nervous, because I reasoned that 5 pee sticks couldn't possibly be wrong. I knew there was enough hcg in my system to ensure happy news when I got the phone call that afternoon. And sure enough, my nurse called and congratulated me, and told me my hcg level was 637. Holy shit! It might be twins! We fought the urge to tell everyone we knew. I felt like I wanted to take out an ad on the nearest billboard, After FIVE years, we FINALLY did it! WE ARE GOING TO HAVE A BABY! A BABY! Us! We are pregnant! We told WAY too many people. Family and all the people we really love, but still, I know now, way too many people. We were just so overcome with this news, it was incredible, unbelievable, we felt like we had won the lottery. We talked about things that we have NEVER allowed ourselves to talk about since waaaay back when, 5 years ago, when we first got married and naively thought that all we had to do was stop trying NOT to get pregnant and we'd get pregnant. We talked about what we'd do with all the furniture that is in the spare room in order to turn it into a nursery. We talked about possible names, we talked about child care options, we talked about what the baby might look like, whether each of us wanted a boy or a girl.....I started reading "What to Expect When You're Expecting" again, which I also hadn't allowed myself to read since right after we were married. I can't remember a time when I felt so thankful, so happy, so hopeful and joyful....it was a magical week.

Thursday, Aug 27 - I was ridiculously sure of myself going into my second beta on Thursday morning. I knew that my levels of hcg were supposed to have risen at least by 60% in two days. I had calculated that meant my number needed to come back around 1050 or more, and I was honestly absolutely positive that I would surpass that number with ease. I wasn't even nervous. How are you this morning, the nurse asked me as I rolled up my sleeve. I'm FANTASTIC, I said, grinning like a cheshire cat. Supremely overconfident, and supremely naive and stupid, as it turns out. When my phone rang that afternoon to receive the results of the blood test, I was so excited to hear how my number had come back, and was anticipating going online to see if all the hcg charts still thought I was going to have twins. When Dr. G himself began speaking, instead of one of the nurses, I instantly knew it was bad news. He told me my level had only risen to 679. Not a good sign, he said. I could hardly breathe I was so shocked. I hadn't prepared myself AT ALL to hear bad news, hadn't even thought it could be a possibility. He went on to say that the level on Tuesday had been so high, and he thought it was possible that initially two embryos had implanted, but perhaps one of them had stopped growing, and that the other one was still fine. He said that they had definitely seen cases where that happened, and the remaining embryo went on to become a beautiful full term baby. That I shouldn't worry myself to death over the weekend, and that I should come back in on Monday for another blood test and an ultrasound to see what was going on in there, and hopefully my number would jump up and everything would be fine. I got off the phone, called R, and totally lost it. Was sure for about 3 hours that it was all over. Left work early, raced home to be with R who was also off that day, and laid in bed with him crying for over an hour. R is a steadfast rock of support in situations like these, and as he always does, he pulled me up out of it and helped me to see that there was every reason in the world to believe that it was just as Dr. G had said, our remaining embryo was strong and everything would be fine on Monday.

Monday, Aug 31 - after an eternity of time over the weekend, we went trembling into the fertility clinic for the 3rd beta. I was almost shaking I was so nervous. As I sat down in the chair to offer up my vein for the blood draw, one nurse asked the other, confirmed or suspected? My nurse answered, suspected, and then handed me a sheet of paper detailing the benefits of taking Methotrexate to dissolve ectopic pregnancies. What? Ectopic? huh? I hadn't even thought of that possibility until that very second, but gee thanks so very much for suggesting it. On the way down to the ultrasound room, I tried to explain to R why I was crying again, and why they seemingly suddenly thought our pregnancy could be ectopic, and then we both tried to figure out why they thought it prudent to provide us with the information and a consent form for methotrexate before we even had the effing ultrasound for christ sake. During the ultrasound, R stood there holding my hand while the doctor explained (not my beloved Dr G that morning, unfortunately) that although it was VERY early and they couldn't tell anything absolutely for sure, that she definitely saw what could very well possibly be, and most likely could maybe be, a pregnancy sac. But no, they couldn't rule out an ectopic pregnancy based on the ultrasound, bc it was really much too early, I was only 5 weeks that very day, and it's just so early to really tell anything definitively on ultrasound you see. Aaaaaarrrrrrggggghhhhh. R was steadfastly positive, as he always is, and focused on the fact that the doctor had ended on a positive note, "as far as I can tell, this is a pregnancy sac, and I would say that you definitely should NOT take the methotrexate at this point. We need to see what your hcg numbers look like this afternoon, and then we'll have a better idea of how we should proceed.." So, R and I both went off to work and I waited in horrible suspense for the next 4 hours for the fertility clinic's call. This time it was the nurse who called, but her news wasn't any more positive than Dr G's had been 4 days before: in 4 days, my hcg level had only risen to 713. She didn't offer any color commentary on the predictive nature of this number on our unborn child, but rather stated in a very serious tone that Dr G wanted to see me and perform an ultrasound HIMSELF in three days, and that he had arranged to meet me at the clinic on Thursday at 8:15, as long as that worked for my schedule. As if there were ANYTHING more important to me than this pregnancy! Sorry, getting my nails done at 8am, could Dr. G do 10, 10:30? yeah right.

Thursday, Sep 3 - I went by myself to the clinic this morning, feeling defeated and depleted. Dr G performed the ultrasound, and he was incredibly thorough. It took twice as long as it usually does. He said that he saw several cystic areas that might or might not be pregnancy sacs. He said that normally, at 5 and a half weeks, that he would expect to see white lines differentiating a pregnancy sac, which he didn't see on mine, and that he would also have expected the sac to be larger. The several areas that he saw in my uterus which MIGHT be pregnancy sacs were all quite small. Still, he said, knowing that this pregnancy is very much wanted, I want to give this every possible chance...let's see how the numbers come back this afternoon, and I want to see you on Monday, when you'll be 6 weeks, for another ultrasound. He said that at 6 weeks, on ultrasound he would expect to see a large pregnancy sac with a yolk sac clearly visible in it. If we didn't see that, and my numbers continued to creep upward, he would recommend starting the methotrexate. If there were any chance for this to be a viable pregnancy, he said we would have to see the numbers rise quite dramatically this afternoon, and we'd have to see that pregnancy sac with encompassed yolk sac on Monday. So, I left really feeling like there was very, very little hope. And more than that, feeling so terribly frustrated that this horrific suspense continued to drag on. The typical rollercoaster of infertility, only in a condensed way that I hadn't experienced before now. When the numbers came back this afternoon, 774, Dr G again called me himself, and said that given the lack of conclusive information from this morning's ultrasound, and the modest at best increase in my hcg level today, that he strongly recommended that I go ahead and take the metho injection. He told me that he felt there was almost no possibility that this pregnancy was viable, and that if we let it go on, there was a risk of my tube rupturing, if indeed it turned out that it was an ectopic pregnancy. He didn't feel there was any reason to wait and do another ultrasound on Monday. I cried, and called R, and drove myself bleary eyed back to the clinic. The metho injection is not only intramuscular, it has to be injected in two different injection sites in order to increase the absorption potential. Apparently the protocol for this is for the patient to assume the position, standing with trousers lowered and with palms braced on the examination table, while not one but two nurses armed with extra long needles face off behind you and stab you at exactly the same moment on opposite sides of your posterior. I had gotten intramuscular shots before when we did IVF, but R always gave them to me, and I always iced the injection site beforehand so that I never had to feel anything. Unfortunately ice wasn't part of the protocol this afternoon, and those two shots hurt like hell. I am proud to say that I didn't cry until well after the shots were over, when one of the nurses reached out and patted my arm and told me she was so sorry that she had to do it, and that she knew my heart was hurting worse than my rear end. That small act of kindness was too much for me, and I had to sit in the exam room with a box of tissues for several minutes before I could collect myself enough to walk out to the front desk, where I was told I needed to make a date for another two needles full of metho on Monday. That should make for a delightful Labor Day holiday - a trip around the beltway at 8 am to get two more intramuscular injections. Could this get any better?

So, there's the whole sad story. I feel completely wrung out now, and my eyes are are puffed up to the size of extra large marshmallows. Right now I wish more than anything that I could will my body to go ahead and get the mechanics of the miscarriage out of the way RIGHT AWAY. I'm told it could be two weeks or more before my body will decide it's finally time to expel the embryo, or materials of conception, or whatever I'm supposed to call it. I wish I could make it happen tomorrow, I would gladly stay here locked in my bed or bathroom suffering with cramps or pain or whatever may come, for hours on end, if I could only just get it over with right away. I can't stand the idea of walking around in this strange state. Still technically pregnant, but decidedly not. But like everything else about infertility, I have absolutely no control. My body will do whatever it will do, and I'll just be along for the ride.

Perhaps I will post more when this is all over. We're going to the beach in a week, I can only pray that I won't spend my one week's vacation this year dealing with the mechanics of an inevitable miscarriage.

Edited on 12/2 to add dates and corresponding beta numbers, purely for my own future reference:

8/25 - 637
8/27 - 679
8/31 - 713
9/3 - 776
9/7 - 507
9/10 - 324
9/15 - 91
9/22 - 0

Resurrection

Strange to be back here again, yet, here I am. Thought I might as well start logging my thoughts on infertility again, as I've finally taken some action today, after a very long hiatus. I went back my beloved RE this morning, for the first time in almost 2 years.

It was a surreal experience, sitting in front of him and listening to him recite my 5 history from notes on his computer screen, "Clomid in 2004 and 2005 with no response....protracted IUI cycle in 2006 resulting in an egg reduction procedure and mild ovarian hyperstimulation....IVF cycle in 2007, 14 eggs retrieved, all mature, all 14 fertilized, half of them abnormally. unsuccessful. recommended another round of IVF with addition of ICSI and assisted hatching..."


I sat across from the good doctor feeling somewhat accomplished. I'm 80 pounds lighter than last I saw him. I told him that for the first time in my life I had been having "regular" (40-ish day long) periods. I told him I had been waiting for a miracle. He smiled and said that response was common, human nature, understandable.

I told him I had said the same thing to my ob-gyn 2 months ago, who promptly responded, "You are 38. You don't have time to wait for miracles. Go back to your RE as soon as possible. Make an appointment today."


It took me two months to work up the nerve to jump back into this. In large part, I'm absolutely dreading it. A smaller part of me is starting to feel hopeful again, after only one consultation. I think that is very, very dangerous. Dangerous, but inevitable.


In the almost 2 years that have elapsed since we were officially "in treatment", my personality has changed. For the better, in my opinion. Granted, I may have been in denial during that time. But, it was a far more pleasant existence, being off of the roller coaster. I was able to set all of the constant plaguing daily heartache aside for a while. As I've said before, infertility is a problem that never goes away and has no good solution, no matter how often you analyze it, no matter how many different ways you look at it and turn it around in your mind. It's exhausting to have it top of mind every day. I don't miss walking around with my emotions and vulnerability so very close to the surface. I don't miss bursting into tears for no reason whatsoever. I don't miss feeling pitiful and pathetic and like a failure every day. I am so very fearful of going back to that place, and being that person again.


For practical reasons, I'm also dreading the logistics of getting back into a treatment cycle. I'm working longer hours and have a much more demanding schedule than I have since we began "trying" all those years ago, and I can't quite imagine how this is going to work this time around. The idea of telling my colleagues that I can't schedule any meetings before 10am is laughable.


But, we had some heart to heart talks, my wonderful hubs and me, and decided that there will never be a good or favorable time for getting back into this - not financially, nor physically, nor mentally. We must make it a priority whether we like it or not, because the statistics are stacked against us. No spring chickens, we two.


So. Here I am again. Preparing for another ride on the roller coaster...

Has it really been 4 months?

Wow, it's been quite a while since I felt I had anything to say on this blog that would be worth anyone's time to read about.

I guess the bad news is that nothing much has changed. IVF is still our only hope, and we still can't seem to commit to a plan for how to fund another try. I still feel like our time is running out. R turned 39 this month, which means I'm not very far from 38 now. Not the end of the world of course, doesn't mean pregnancy is impossible, but certainly doesn't do anything to improve our odds, either.

I suppose the good news is that I'm not as despondent about infertility on a daily basis as I have been in the past. I think that is because the longer we are stalled, the longer I allow myself to be apathetic about it, the easier it gets to....not do anything. I'd be lying if I said I was looking forward to being embroiled in a treatment cycle again, taking the injections, conforming our daily lives around the cycle, opening my heart up to hope again, bracing for the inevitable crash....I'm really dreading having to go through that all over again, actually. But still, if a big pile of money fell out of the sky tomorrow, I'd haul it straight to the RE's office and plunk it down, sign up for another chance.

We entertained R's family this afternoon and evening....had our usual Sunday afternoon cookout, as we do most Sundays in the summer. Today there were 15 adults, 7 children, and 2 dogs running around in our little house. It was a madhouse, of course, but we loved it. At the end of the evening, R's cousin asked if her 3 kids could take a quick bath before they left. They had to drive at least 45 minutes to get home, and she knew all 3 would be conked out in the car and difficult to harangue into the bathtub once they got home.

The sight of those 3 precious and precocious little ones in my bathtub pulled at me in a way that seeing them run around all day had not. As I helped to dry them off and muscle them into their 3 sets of clean and color coordinated PJ's, my main thought, of course, is that I should have been bathing my own children in our bathtub, not someone else's. I should have been putting PJ's on kids in a room decorated with zoo animals and ABC's, not in the room that serves as our "extra den" instead.

But remarkably, bitterness and self pity did not overtake me tonight, as they so often have in similar situations in the past. I feel a sense of hope about it all....although I can't say I know exactly why. Maybe because after all this time I still believe in miracles. Because I think R and I are good people, and because I still believe that good things do happen to good people. For tonight, that's enough reason to keep hoping.

Still here.....

I confess that I have been avoiding this blog. And I have also been avoiding all of your blogs. I know, selfish, right? I can't help it. The IF blogosphere has really depressed me since the New Year.

We don't really have any concrete plans set in place in terms of 'trying' in the near future. My body has refused to cooperate with our desire to start a family for almost 3 and a half years now. Because of the PCOS, I don't ovulate, so there's no chance for us to turn up miraculously pregnant while trying on our own. For what it's worth however, I refuse to remain on birth control pills while in limbo. Instead, every 2 or so months I call my RE's office to get a prescription for progesterone to induce a period. For the privelege of this endometrial-cancer staver-offer I must submit to a pointless pregnancy test administered in the RE's office.

I went for one at the end of January. It was very, very strange. I felt like I didn't belong there, like everyone could see that I wasn't really trying and why was I wasting the time of the staff there. Just months before I had felt like that waiting area was my second home. I knew all the nurses by name. I felt productive and dedicated and hopeful when I was climbing in and out of the stirrups 4 and 5 times a week. When I went in January I felt like a fraud and an outsider. It was weird to feel so far removed from that whole 'sisterhood of cycling' thing.

I guess I was also feeling that way about this blogging community. I can't read the blogs of those who are pregnant. I know I don't have to justify that to anyone, even though it does feel really shitty to admit it right out loud. And for every happy preggy blogger, there seem to be as many heartwrenching losses in our community of late as well. Reading about the horrific pain that so many are in, particularly Mary Ellen and Steve after losing their triplets - it just makes me nauseous and sick. And in this limbo-land, reading all the other blogs of those who are back up in the saddle (and stirrups) and are earnestly, hopefully, dutifully trying again - those just make me feel like a lazy loser.

The fact is that our only, only, onliest hope is IVF. And we simply cannot afford it right now. Who knows when we will be able to do so? There's a potential recession coming. We've had unforeseen expenses over the last 6 months, smaller bonuses and tax returns than we were expecting, and the housing market continues to decline. So, I honestly don't know when the next opportunity might be for R's sperm to meet one of my eggs. Possibly not until next year, by which time R will be 39 and I will be 38. Lately I've allowed myself to think about the fact that it might just be too late for us. I have prayed and railed and asked God - are we not meant to be parents? I still have no answers of course.

I'm just trying to take things day by day. As of tonight, I'm caught up on all of your blogs, and although I probably won't be commenting as much as I have in the past, please know that I'm back and keeping up with all of you again.

For my own sanity, I'm going to try to post my thoughts more often here, and not just when I'm feeling particularly sad. I promise to blog some joyful things every once in a while, as I have SO many things to be thankful for. As melancholy as this post has come out - there is still much joy in my life. I'm trying very hard to concentrate on it!

Angel in Alabama

Sometime last week, just a few short days after pouring out my heartache on this blog, I arrived home to find a package on my doorstep. It turned out to be an unexpected gift from Kellie, my angel in Alabama.

She sent me a beautiful little figurine, as well as the most inspiring and tear-jerking card you've ever read. Kellie's main message was this: I understand your pain, I'm sorry you're hurting, and there is reason to hope.

This unbelievably kind gesture from a woman 1,000 miles away who I've never even met - it lifted me up indescribably. It also brought on yet another freshet of tears - but not the same desperate kind of the past few weeks. These were tears to acknowledge that Kellie's words might? will? definitely will? come true: "K, you WILL be a mom."

This beautiful little figurine, with its little arms and hands outstretched, and its small face turned up to God - it's the last thing I look at before I go to bed each night. It is a heartwarming and much appreciated reminder to keep Hope alive.

Thank you Kellie, your gift means more to me than you will ever know!

Melodrama

I wish I could say I've thrown off the pall of sadness that was cloaking me the last time I posted (just before Thanksgiving.) Unfortunately, if anything, it's gotten worse. I feel so.......vulnerable, I guess. Kind of fragile - like any little thing could send me into a crying, pity-partying meltdown.

I feel anxious all the time, and more than that, I've become aware that I seem to be constantly bracing myself for hurtful news of some kind.

I look at our little dog Murphy lately and all I can think is how wrenchingly sad it will be when he eventually dies. He's only 9 years old, and I'm not expecting him to go any time soon. But for some reason I cry every night when I cuddle up with him, and wonder how I will be able to get out of bed and go on with my life when he dies.

Every time we see friends I find I'm bracing to hear that they are pregnant (again.) Or when the phone rings my brain kind of winces, wondering if there will be horrible or sad news, or some other hurtful knowledge on the other end of it.

I feel needy and dependent. The slightest mood change in R has me spiraling into thoughts that he's going to leave me...if not now, someday. I've lost my faith in happy endings. I feel cynical. Empty, except for the tears that seem to be always right behind my eyes.

I hate myself for being this pathetic person. I'm so weak. I have SO much to be thankful for, and I have to really FORCE myself to recognize that on a constant basis. I would much rather sit around feeling ridiculously sorry for myself. All the time.

I'm also an ingrate. R took me out to a fabulous, expensive, special and romantic dinner for my birthday a week and half ago. All his idea. Instead of enjoying spending a special evening with him, and savoring time spent together (which is really the most important thing), and appreciating the substantive price tag of the bottle of wine and filet mignon, I cried in the night like a 5 year old because he didn't give me an actual gift to open. AAACCKK! I'm so not this person.

My God, I just read over this and it's so freaking melodramatic. Blech!!!! But, it's what I'm really feeling. Ugh. I don't know how to snap out of this.

I'm simultaneously looking forward to this Saturday, and dreading it with my entire being. I'm forcing myself to attend an adoption 'convention' in DC, where I'll attend seminars to get educated on the facets of international vs. domestic adoption, open vs. closed, costs, timeframes, etc.

I want to go, and learn, and understand our options. I'm also weighed down by the idea of it - overcome with sadness. I keep picturing myself wandering all over this huge convention surrounded by pictures of babies and children who need someone to love them. It should feel empowering to educate myself about our options. Instead it makes me feel like sobbing until I can't stand up straight.

********************

I just had to dash off the bathroom. R just sent me an email that yet another couple, who got married right around the same time that we did, are now expecting their first child. They think it's a boy.

By this point I think we infertiles understand each other. You know that of course I'm happy for them - thrilled they don't have the same problems that we do. They must be so happy! How perfect to announce their pregnancy right around the holidays. That's what I've always dreamed of! These two are such a wonderful couple and will make fantastic, smart, compassionate, responsible parents. I bet their child will be gorgeous! And, OF COURSE I'm glad they are pregnant. I wouldn't wish infertility on my worst enemy.

But the truth is, when I first read the email I instantly starting crying. My first thoughts were: Poor me! Why not us? That should BE us! Oh God, please help us, our hearts are breaking! I don't know what to do anymore.

Happy Thanksgiving

Well, I don't feel at all worthy of this, but my dear Jenna has suggested that I belong on her list of Distinguished Blogger Flame of Fortitude honorees. Although I humbly appreciate her tag - I've been feeling so un-thankful and un-thanksgiving-ish this week that it feels counterfeit to even post about this. Ugh.

I've been feeling so sad this week - I can't seem to get into any kind of holiday spirit. Usually by this time I'm feeling warm and fuzzy and spiritual and reflective and all of that. But this year I feel like I'm digging waaaaay down and the warm fuzzies just aren't coming. I'm going to try VERY hard tomorrow to dredge up some thankful-ness and put on a happy face and appreciate time with my family. But it won't be as natural as it normally is. I keep breaking into tears for inappropriate reasons and at inconvenient times. I had to race off to the bathroom several times at work this week before any one saw me having a "moment". I really, really hate feeling this pitiful.

I hope to post something much more cheerful, or at least productive, after we get back from Thanksgiving. Hope all of y'all in the US have a wonderful Thanksgiving holiday tomorrow with your families and friends!

Hello again!

I can't believe it's been over a month since I posted anything here - I'm sorry I've been such a silent blogger! I have, however, been diligently keeping up with all of you. There's been happy news out there, as well as deeply, deeply sad. I've been rejoicing and grieving right along with all of you.

So firstly, Congratulations to Faith! I've been reading along with her since before her successful IVF cycle. It's hard to believe it's been 9 months, and then some! Go and see her beautiful new boys, here.

And if you haven't already been over to visit Cam or Ann during this soul-crushingly sad time, please do - and if you're behind in your reading, like I was last month, go and give some love to ISOMorning Sickness, too. They all need our support now more than ever.


So, you may have guessed that since I haven't been fervently blogging and posting loads of detailed accounts of treatments lately, that we're taking a break. Oh the consternation that is bound up in that phrase: taking a break. Usually in our case all breaks have been physician-mandated ones - wait for a cyst to go away, wait for my lining to thin out, take another cycle of BCP's, etc. This time however, we mandated the break.


We were supposed to start IVF#2 when we came back from our annual Outer Banks beach vacation the first week of September. The several thousand dollar water-pipe repair emergency the second week of September put the kibosh on that month.

So then we were supposed to start in October.....but in the beginning of the month I suddenly realized the origin of the feelings of dread that I had been unconsciously carrying around for several weeks: I was dreading starting a new cycle. I had fallen into a comfort zone, pretending the problem didn't exist, or I was at least relieved not to be consumed by dates and calendars and shots and worries of impending doom for a while. I just blithely ignored the irony of taking my birth control pills each and every night, having been given license to do so by the perpetually pending cycle that was going to start any-minute-now. More than anything I realized how effing tired I am - bored, I would even say - with the whole being-infertile thing. I'm tired of being sad, I'm tired of agonizing over every cycle, I'm tired of worrying about where the money will come from to pay for treatments, I'm tired of structuring and scheduling every other part of lives around the unknown and un-plan-ahead-able requirements of treatments. I'm tired of saying to myself on every holiday or otherwise momentous occasion: I wonder if I'll be pregnant by this time next year? I'm tired of answering the question "Do you have kids?" with an answer like "Not yet!" I'm so, so, so tired of being the person that everyone feels sorry for. I'm even more sick and tired of feeling sorry for myself. I'm tired of thinking about fertility all the time, every day, every week, every month. I'm tired of feeling a sharp pang to the heart when I hear that someone else I know is pregnant, with their first, second, third child. I'm tired of waiting for my life with children to begin. I'm tired of hanging out with other people's children and wistfully thinking of the ones we don't have yet. I'm tired of thinking "someday." I want someday to be soon, now, today. I'm tired, dare I say it - of even talking about this! None of what we have been through in 3 years has made one iota of a difference to the bottom line - Nothing has changed in 3 years: I'm still not pregnant and we still don't have a child.

R and I had several long discussions in October about what we should do - or, I guess more accurately, when we should do it. We decided that it would be very difficult to face the emotional, financial, and physical stress of doing a cycle so close to Thanksgiving and Christmas. I was picturing myself fighting the throngs of people in the malls with bags of gifts and having to duck into messy public restrooms to stick myself with needles. Or being at Thanksgiving dinner all hopped up on hormones and bursting into tears for no outwardly apparent reason. Or receiving the crushing, blackening news of a failed cycle - malfunctioning body, money down the drain, yet another disappointing setback - just before Christmas.

I just didn't think I - we - could handle it. So we've decided to wait until January to embark upon IVF#2. It wasn't an easily reached decision however. At least, not for me. I'm all wound up about the fact that three days from now I'll turn 37. Only 3 years left until I'm 40. I can vividly remember when my mother turned 40, and I thought she was ancient. I don't feel ancient yet, certainly. But when I let myself contemplate the full weight of being thirty-seven years old.....I feel a sense of panic, like there's a rising tide that is swelling up faster and faster, and my legs are buried in the sand. I feel an overwhelming sense of urgency to do something, anything, just do it quick because time is running out! But yet, there's nothing else I can do. Is there?

Well, that actually brings up an issue for another post - I went to an adoption fair yesterday at work. I'll devote an entire post to that emotional event, next.

In other news, I've decided that during this non-cycling down time I should concentrate on eating healthier and losing some weight - getting more fruits and vegetables into my diet, and cutting out bad fats and bad sugars, etc. I decided to try Weight Watchers, for the first time in my life.

I've struggled with my weight my whole life. I went on my first diet when I was 9. I've had a lifelong love-hate relationship with my bathroom scale, let me tell you.

Anyway, one of the reasons I've always been turned off by Weight Watchers was the thought of those gruesome in-person Weight Watchers meetings where all the middle-aged ladies in their elastic waist pants congregate in the fellowship hall of the local baptist church and celebrate losing 1/8 of a pound every week and swap recipes for lightened up versions of tuna casserole. Blech!!!

So, maybe the fact that I finally decided to try this has something to do with the fact that I'm finally accepting my OWN middle-agedness? Or maybe it's because a co-worker told me she hates the idea of going to meetings too and that you can join 'anonymously' online. Who knows? But for better or worse I joined in October, and I've lost 16 pounds and one pants-size so far. Not bad. It hasn't really been that hard to adhere to - that really surprised me. The thing I really like about Weight Watchers is that you can eat anything - anything at all - and it doesn't cause a collapse of your whole diet/system/plan so as to send you into a tailspin and cause you to immediately throw in the towel and begin planning for when you'll RE-START at some point in the future. That is usually my downfall with diets - especially when I was doing Atkins years ago. One slice of bread and you were completely ruined! Knocked out of fat-burning ketosis by one bite of mashed potatoes! It would be days before you could get your bodily chemicals back into the precise balance required to burn the fat and lose weight! There's simply not enough wiggle room in a diet plan like that - at least not for me. It leads to the pound-packing mentality of - "Oh well, I've already gone off the plan today by eating that Snicker's mini from the Halloween candy bowl. It's all downhill from here. Might as well 86 that salad I was planning to eat for lunch and have a grilled cheese instead." But Weight Watchers is much more forgiving. If you eat the Snickers mini, it is not the end of the world, or even of your day. Just means you must adjust your food intake for the rest of the day to compensate. It makes for faaaar less guilt than I'm used to shouldering when it comes to food. This is sad to admit, but I've become accustomed to feeling guilty every time I eat something - no matter what it is. I think Weight Watchers helps people like me to let go of at least a little of that food-guilt, and for that reason I think it's been good for me so far.

But the season that is by far my biggest downfall during this time of year, the thing that strikes fear in my dieting, salad-munching, saturated-fat-avoiding heart, is well upon us. Thanksgiving, you ask? Christmas? Hanukkah? Kwanzaa? Nay, nay - even worse, and MUCH more insidious and long and draaaaawn out: Football Season. Aaaaaaggggjhhhhhhh!!!!

Every Sunday whilst watching the Redskins (lose) I'm assaulted by chicken wings, beer, chips, cheese dip, brownies, beer, chips, pizza, beer, chips....did I mention beer and chips? I'm a sucker for beer and chips. I think I could subsist on beer and chips alone, if the case arose on a deserted isle.... And the worst part is that all this food is usually at my OWN HOUSE! We tend to entertain very frequently during football season. So, invariably, if I'm tempted to go 'off-plan' as the Weight Watchers say, it's on Sundays.

So instead of serving the good stuff for all of our friends, and then forcing myself to either abstain or cry into my celery and carrot sticks all afternoon, I've endeavored to find some recipes for less fat-laden, but still football worthy things to serve on Sunday afternoons.

To wit, the delicious and road-tested recipes cut-and-pasted below (from the Weight Watcher's website.) Everyone at our house has enjoyed these, hope y'all will too. Enjoy!

(For anyone else who happens to be counting Weight Watchers Flex Points, the chicken wings recipe makes 4 servings at 4 points per serving, and the chili recipe makes 10 servings at only 1 point per serving, not including the baked tortilla chips you'll include for dipping.)




Buffalo Wings with Blue Cheese Dip

Ingredients
1 sprays olive oil cooking spray, or enough to coat sheet
12 oz uncooked skinless chicken wing(s)
1 1/4 oz Old El Paso Taco Seasoning Mix, or similar product
1/2 cup fat-free sour cream
2 Tbsp blue cheese, or gorgonzola, crumbled
2 Tbsp fat-free skim milk
4 medium stalk celery, cut into 2-inch pieces

Instructions
Preheat oven to 400ºF. Coat a large baking sheet with cooking spray.

Place chicken wings in a zip-close plastic bag, add taco seasoning, seal bag and shake to coat. Transfer wings to prepared baking sheet and bake until cooked through, about 18 to 20 minutes.

Meanwhile, to prepare dip, whisk together sour cream, cheese and milk.

Serve wings with dip and celery on the side. Yields about 3 wings, 3 tablespoons of dip and 1 celery stalk per serving.




Chili Party Dip

Ingredients
15 oz canned turkey chili without beans
8 oz fat-free cream cheese
4 oz canned jalapeno peppers
1 small onion(s), finely chopped
1/2 tsp hot pepper sauce

Instructions
Combine all ingredients in a saucepan.
Cook over medium heat, stirring frequently, until cheese melts, about 10 minutes. Yields about 1/4 cup per serving.

Misinformation

Did y'all see the Oprah show yesterday (Tuesday) about infertility???? I tivo'd it and watched it last night. I was prepared to get riled up, based on what happened when our friend Jenna, bless her heart, was on last time.



But geeeeez, what a train wreck!! I found both segments to be TOTALLY infuriating. What an unbelievable dearth of detailed information!

The first segment was about a couple who went to India to hire a surrogate. The issue the show concentrated on was whether this cottage industry of surrogate Indian women having babies for white American women constitutes exploitation. The facts: cost of hiring a surrogate in the US: upwards of $80K; cost of hiring a surrogate in India: ~$12K (presumably not including travel expenses); amount of money received by Indian surrogate mother (which is purportedly more than most women earn over their lifetime): ~$6-$7K. Oprah stated that in her opinion this was not exploitation but rather women helping other women across the world - the American woman gets what she most desperately desires and otherwise could not afford to pay for in the US, a biological baby. The Indian woman receives what amounts to nothing short of a transformative amount of money - enough to drastically improve her family's living conditions, quality of life, and to ensure a bright future for her children by providing them with higher education. Personally, I agree with Oprah on this one, but can nevertheless understand the controversy.

However, there was absolutely NO background given about the American couple and exactly what their specific infertility diagnosis was. They merely stated that they had been "trying" for 3 years, and had spent a total of ~$30K so far. This is troubling because I believe it's a common misconception (no pun intended) that surrogacy is a widespread solution to general infertility. However, this is the exception rather than the rule.

As I was watching, I longed for the couple to share more about their personal experience - what was their diagnosis? Why did their doctor believe that surrogacy would be a viable option for them? What treatments had they tried and failed previously? There were no details given about this. I was trying to imagine that I was still a smug, ignorant, not-yet-trying-to-get-pregnant-and-so-have-no-clue-of-what-could-go-wrong woman. What might I take away from the segment? That even if I eventually discovered I was having trouble getting pregnant, that there was no need to worry, bc I could always get a cheap surrogate in India. Not to be too crass, but that might very well have been the main take-away from that whole piece for some people!

So, as if that part of the show wasn't bad enough, the next segment was an interview with Alexis Stewart, daughter of Martha. Now, I'm not a fan of Alexis' anyway, just based on listening to her awful radio show on her mother's Sirius channel. At least from her radio persona, she comes across as a spoiled, foul-mouthed, ill-mannered brat of grown woman. Not completely surprising, given who she is, imho.

However, I'll start with the positive: Alexis did make a good point in the top of the segment as to the illusion that celebrities create by having children late in life, and that this creates this false sense of security for women, as in, "Hey, Halle Barry can have a baby in her 40's, so I don't even need to start worrying about my own 'biological clock' until my late 30's at the earliest! If celebrities can do it, anyone can! Great!" I totally agree with Alexis on that point, and also that it is really frustrating that celebrities won't own up to the fact that they are using some type of assisted reproductive technology in order to have these child bearing successes so much later in their lives. No one ever admits to using donor eggs, which perpetuates the myth that one's own fertility can and will remain viable into the 40's and even 50's. This lack of acknowledgement on the part of those in the public eye is only continuing to contribute to the shame and pain of the infertility struggle that affects so many of us today. So, Alexis hit the nail on the head with that, as far as I'm concerned.

BUT, what struck me about the rest of her interview was how very misinformed she herself is - even after having undergone a year of infertility treatment. How is this even possible? I myself feel like I could sign up at the nearest med school and teach a fucking class on reproductive endocrinology. After the first year of this shit, I was intimately familiar with the menstrual cycle - the terms used to describe the process, what they meant, the length of each part of the cycle, all the hormones involved, the possible drugs that could assist and what effect they had on the cycle, not to mention all the terminology used to describe my husband's part of the deal, etc., etc., etc., ad nauseum, ad infinitum.

So when Alexis picked up a Lupron needle and said, "So, you take this for the first 2 or 3 days of the month, and it's very painless, and you take this drug to prevent endometriosis.", I wanted to jump through the TV screen. Are you kidding me???!! But my first issue with her comments are that she also didn't share any details of what particular infertility diagnosis she was struggling with. She didn't even say that she was undergoing IVF. Rather, she said that she spends $28K per month on her infertility treatments. As anyone who has ever undergone any type of ART knows, it's physically impossible to complete one IVF cycle EVERY SINGLE MONTH. So all I can think is that her doctor is robbing her blind because she's the daughter of a very, very rich woman. Whatever.

That doesn't bother me nearly as much as the misinformation she was spouting. How about this one: "Yes, so at my age, you tend not to grow very many eggs, so you have to take these drugs in order to stimulate egg production.", or this one, "Over the course of this year I've had around 5 or 6 eggs implanted in me, but none of them have stuck.", or even this: "Well, at a certain point if all of this doesn't work, I guess I'll have to look into egg surrogacy."

I know that all of these miscues when taken alone might not seem like a big deal, but it REALLY, REALLY bothered me that she didn't seem to even care that she wasn't being accurate. I think that there is such a lack of real information out there in the spotlight on infertility, and I really feel like Alexis Stewart should have felt more of a responsibility to educate the millions of viewers of the Oprah show with real and accurate information on her struggle. I think Oprah (her producers) bear a part of that obligation as well. I feel like everyone involved with that show fell woefully short of their obligation and responsibility.

I for one, would much rather hear (see) an interview with a well-informed, prepared-with-details non-celebrity regular old person struggling with this problem - like you or me - than a celebrity who was either unprepared and ill-informed, or perhaps not even willing to share the critical details that define this experience.

To be candid, the whole show just made me angry. It barely, barely even scratched the surface of this complex and seemingly epidemic struggle that impacts more and more women and couples across the world every day. I'm really disappointed.

But, what did y'all think?

Three Years

Happy 3rd Anniversary, baby! My dearest darling, my big strong handsome man, my strength and solace. Three whole years we've been married, and I still wake up every morning excited to spend the rest of my life by your side. I love you more than all the stars in the skies and more than all the fishes in the sea. Here's hoping that this will prove to be "our" year, and we'll finally make our dreams come true, together. I love you!


****Our actual anniversary was yesterday, but for some reason I couldn't get this post to go through yesterday.....

Back to Reality

We're back from our beach escape! One week in the Outer Banks is never, ever enough. Every year I ask myself if there's any humanly possible way that we could manage to stay for 2 weeks the next time we go. I've never taken 2 weeks off in a row - seems impossible but I know that there are some who swear by 2-week vacations.

The week before we left the mean weatherman was predicting rain for 6 of the 7 days we were to be there, and I was freaking out. However, beach weather is always fickle, and wouldn't you know we managed to somehow luck into perfect weather every single day! Never rained so much as a drop until Saturday morning as we were packing up the car to come home. Just how I like it!

We ate and drank sinfully, luxuriated in the sun, swam in ocean, pool, and hot tub, romped in the surf with our dog, played golf, went kayaking (Ok actually only R played golf or went kayaking, I concentrated on the luxuriating in the sun part), and drank many, many, many cocktails on a daily and nightly basis.

We also went on a lighthouse sightseeing mission one day towards the end of the week: we decided to drive the 130 miles from the northern most part of North Carolina's Outer Banks, where we were staying, all the way down south and across the ferry to Ocracoke Island. It took us all day, but we saw all four lighthouses most often associated with the Outer Banks: Currituck Light, Bodie Island Light, Cape Hatteras Light, and Ocracoke Light. It was quite an adventure!

Anyway, now that we're home, all I can do is pine away and wish we had never left the beach!!! Siiiiigghhh.....

Compounding my lack of enthusiasm for returning to reality, we came home to a leaking water pipe in our front yard. Actually, on the second day of our vacation, our neighbors called R's cell phone to report that they had seen a "small lake forming in our front yard" and they wondered if we'd like them to call the water authority to have our water turned off until we came home? Um, yeaaaah, that seems like a wise course of action! I began to fret over this lovely piece of information until R reminded me that there was absolutely NOTHING we could do about from North Carolina, and as such, we shouldn't ruin our entire week's vacation worrying pointlessly over it. He was right, and I tried to put it out of my mind for the rest of the week. (yeah right)

But, now we're REALLY back to reality, and the repair people are coming tomorrow morning to excavate the old pipe (all the way from the edge of our property at the street, through the yard, through R's perfectly manicured grass, through our borders with impatiens, otto luyken cherry laurels, hosta, etc.) and then install the new one.

Isn't it fun to spend $4,000 the weekend after you get back from your annual vacation? Especially when it's 2 weeks before you were supposed to spend $10,000 on your upcoming IVF cycle??

Given this state of affairs, R and I made the somewhat difficult decision last night to postpone our IVF cycle for at least a month. We'll need at least that long to determine how to scrounge up the necessary sack of money to proceed. It's really the only thing we can do. Having running water in the house is not exactly a luxury.

Sooooo, instead of starting the Lupron injections this Sunday, as I had been planning, I probably won't be starting them until sometime around Halloween. But golly gee, in the grand scheme of things, what's another month? We've already been at this for 35 months. Hell, might as well make it an even 3 years.

Just checking in....

Well, I have absolutely nothing of interest to report, but was feeling delinquent for not having posted anything lately!

We're just killing time until our vacation to the Outer Banks in NC next week. Woooo-hoooooo! So, hum drum, ho hum, bring on the beach vacation and accompanying cocktails! I'm soooooo ready for a vacation, I can't even tell you.

Did I tell you that my master plan of manipulating the birth control pills to time perfectly with the end of our vacation was foiled? Curses!! Dr. G said that I couldn't stay on the BCPs for 5 consecutive weeks, because the risk of over-suppression was too great - especially for a long-responder like me.

So, I have to take 2 whole months of pills. Boo hiss. Luckily the first pack ended last week, so I'm getting my blasted period out of the way this week. The good news is that I won't have to contend with a period whilst swimming in ocean, pool, or hot tub next week, nor will it cramp our opportunities for vacation er, romance. Thank God!

Bad news though, is that instead of being able to start stims IMMEDIATELY upon returning home from vaca, I'll have to wait an additional 3 weeks. You know that doesn't set well with my immediate gratification driven psyche, but what can I do?

I guess that does give us a stay of execution in terms of writing the enormous check to pay for this next round. So that's good.

Anyway, just wanted to say that I'm still here, and still keeping tabs on each of your blogs. Wishing all the best for each one of you!

Now what?

R and I have been going around and around the mulberry bush, as they say, on what action to take next in trying to start our family. After many days of soul searching and lots of knock-down, drag-out tearful conversations, I think we have finally have a mutually agreeable plan, at least for the very near future.

The crux of our difference in perspectives is this: R is tired of watching his wife go through endless days and nights of shots and doctor's visits and emotional highs and lows. He is worried about the emotional (and physical) toll that 6 future cycles of IVF (if we sign up for Shared Risk) might have on my emotional well-being, on my very personality. He's ready for us to be parents, now. He is interested in pursuing something that offers certainty and security in terms of an outcome. He is frustrated by the unpredictability of IVF. When considering the prospect of spending over $20 thousand dollars, I think he feels much better about signing up for something that has a 100% chance of putting a baby in our arms at the end of it.

I, on the other hand, am clinging desperately to the idea of having another chance at a biological child, and pursuing that opportunity as quickly as possible. It's the only thought that keeps me from being well and truly 'depressed', as a matter of fact. I'm just not ready to let that dream go. I feel really desperate and out of control; I'm not sure how to change or channel these feelings.

Our endless and frustratingly circular conversations over the last week stemmed from the fact that I'm scared out of my wits that we are heading down a path that will breed resentment in the future. If R feels we should abandon treatment and pursue adoption, and I go along with that, will I wake up 10 years from now resenting that I didn't "try harder" or insist on further opportunities to try for a biological child? If I want to sink a huge amount of our money and our time into 6 further IVF cycles, to the tune of $22K, will R resent me when monthly financial decisions are impacted as a result of this expenditure? Or, if all 6 cycles fail, and the money has been refunded to us, will R resent the fact that we've then "wasted" potentially 18 - 24 months and we're at the starting gate to adoption at ages 39 and 41, respectively?

Bless R, for he is unbelievably supportive and open minded and kept reiterating that in spite of his opinion about being ready to move on to adoption, he respects the fact that it's my body, and will support whatever I want to do next - more treatment or otherwise. Ack! Why didn't I rejoice in this response? Because I want to come up with a plan that makes both of us happy and leaves no room for questioning or second-guessing or resentment at any point in the future. And that is IMPOSSIBLE. There is NO GOOD ANSWER to this dilemma.

From a financial standpoint, we've decided that we simply cannot afford to shell out the full amount required for Shared Risk right now. In the spring when we both receive our annual work bonuses, we could conceivably fund a $20K payment - either for a Shared Risk IVF treatment plan, or for adoption. But not until then.

However, we have almost $4,000 worth of insurance coverage left. If we did one more cycle in the pay-as-you-go format, after adding in all the "extra" treatment options Dr. G recommended (ICSI, Assisted Hatching, etc.) we'd need to come up with about $7K (not including the drugs, of course.)

I almost come out of my skin contemplating the idea of waiting for almost 9 months to try again. 9 months is a lot of time to "waste" when you are trying to get pregnant, especially when you are about to turn 37.

Ultimately we've decided to come up with $7K and try again as soon as we get back from our beach vacation. I'm on BCPs now, so if all goes as planned, I'll likely be starting stims around the middle of September.

I don't know what we'll do if this cycle fails. Wait until spring to try to find $22K (in addition to the $7K we just blew)? Abandon treatment and begin pursuing adoption? I don't know. But I've accepted that I can't make decisions right now based on what may or may not happen in the future. We can only make one decision at a time, based on the current situation and circumstances. At this moment, doing another pay-as-we-go cycle seems like the next right step. Maybe I will second guess this decision. Maybe not.

I'm scared to death that it won't work, again. I'm terrified to think that this could be our last attempt at a biological child. Right now I'm trying very hard to "relax" (yeah right), and am hoping to enjoy our vacation in a few weeks.

Syringes and needles and vials, oh my!

Late last week I decided that I was tired of paying for the little miniature Sharps containers the pharmacy keeps sending me, so I decided that in order to reuse them, I would empty all the full ones I have (yeah, I'm stockpiling full Sharps containers, and I know I have a problem) and put the contents into a recently emptied extra-giant sized laundry detergent container.

So, I dragged all of my bursting-at-the-seams Sharps containers into my kitchen and dumped everything out onto my kitchen counter. (Yes, I know that seems sort of unsanitary, but I reasoned that I could bleach the kitchen counter afterwards...) Anyway, the more I dumped, the more morbidly fascinated I became. I felt a perverse sense of accomplishment looking at all of those spent vials of medication and used needles. (Yes, I know I'm cracked.)

Soon I found myself carefully sorting through the contents, almost feverishly piling syringes on one side, needles on another....

This, I thought, is what hundreds of needle pokes looks like. This is what ONE IUI and ONE IVF looks like. This is what thousands of dollars worth of drugs looks like.

And above, you can see for yourself what it looked like.

For the as yet uninitiated, clockwise from the top left: Empty vials of Menopur, progesterone in oil, and hCG; empty Follistim Pen cartridges; used Lupron needles; used needles; used Follistim Pen needle caps; and used syringes.

Planning for next time

So I managed to get in to see Dr. G this past Friday. He called me on Tuesday evening, the day I got the beta results. He said that he was very sorry that this cycle didn't work, and suggested that we get together as soon as possible to talk about what we could do differently the next time. He suggested meeting on Friday at 2pm, and of course I readily accepted. What a saint.

He recommended several changes for next time: he thinks we should try to shorten my stim as much as we can, bearing in mind that I'm prone to hyperstimulation. Apparently the vast majority of patients have stim somewhere between 9 and 14 days long. Mine was 20. He wants to see if we can shorten it down to around 10-12. He believes that the long stim MAY have resulted in some of my eggs being post-mature. He thinks that may have contributed to our poor fertilization rate. The plan for next time will be to start me off right away with the highest dose of Follistim that I was on last time - 225ius. He'll watch my E2 level closely, and if it takes off immediately and looks like we're headed for hyperstimulation, then we'll immediately back down the dose. But if all goes well, we'll hit the old ovaries with the higher doses right away and see if we can get them to perform in a shorter time period. The hope is also to get more eggs this time around. Dr. G said 14 was great, but 20 would be better.

All 14 eggs they retrieved this time were mature. He said that was great, and was a sign of good egg quality. Of those 14, only 11 fertilized, and 6 of them fertilized abnormally. I'm sure I learned this in some long forgotten biology class, but when the sperm fertilizes the egg, the newly formed embryo is supposed to "kick out" the extra set of chromosomes. In 6 of our embryos, that didn't happen, and so they had 3 pairs of pro nuclei present. Dr. G explained that this could EITHER be caused by more than one sperm entering the egg, OR it could be an egg quality issue. He thinks it was the latter, in this cycle, but he thinks the quality issue can be attributed to the post-mature state of some of my eggs due to the long stim - NOT an overall age-related egg quality issue. So, his second suggestion, to eliminate any possibility of having more than one sperm enter each egg next time, is to do ICSI (for anyone not familiar, Intra Cytoplasmic Sperm Injection).

His third suggestion is to perform Assisted Hatching on our embryos next time around. He explained that this COULD be the reason that our gorgeous, 8-celled, compacting embryo didn't implant this time around. Perhaps it had a little trouble hatching in time to implant?Interestingly, Dr. G explained that although studies have shown no measurable benefit of performing Assisted Hatching on embryos of couples undergoing their first IVF cycle, the data does show that it helps in subsequent cycles. So, I guess his theory is that we might as well give them as much help as we can, and apparently with their embryologist's sophisticated and practiced techniques, there is little danger of harming the embryos when they "chip" away part of the "shell" or zona pelucida before the transfer.

I think it is really mind blowing - all of these procedures they can perform (ICSI, Assisted Hatching, etc.) on these tiny few-celled embryos. I can't imagine being the embryologist responsible for inserting a single sperm into a single egg cell?!?!?! It's almost like science fiction.

What's even more remarkable, in my opinion, is that "natural" conception and subsequent birth ever happens at all!! Every star and planet has to be aligned and every cell in your body and your partner's has to do EXACTLY what it is supposed to do at exactly the right time in exactly the right way......when you think of all the things that can go wrong, it makes you wonder how we managed not to go extinct before the advent of medical intervention! The deeper my knowledge of fertility issues, the more I'm convinced that every child is indeed a true miracle.

So, anyhoo, now the big freakin' question is how the frick we're going to pay to continue with this shit. We only have about $3,000 worth of insurance coverage left. If you add in all the costs of the "extras" Dr. G recommends next time around, we'd have to cough up about $10K to pay for a single cycle. (Plus, we'd have to pay $2,500 for a subsequent frozen cycle, should we be so lucky as to end up with embryos to freeze, of course.) By contrast, $22K would buy us 6 further attempts and/or a guarantee of our money back. We've been talking about it, and we're leaning toward Shared Risk as the logical choice. But $22K is a significant amount of money - do we finance it with a personal loan? Should we borrow from our 401K plans? Should we borrow against the equity in our home? Honestly?...We don't really want to do any of those things, but at some point we're going to have to make a decision and move forward.....

As luck would have it, Friday when I met with Dr. G also happened to be the day that my period showed up. So, he told me I could go ahead and start the BCPs if I wanted to. No pressure though - he said we could "manipulate" the pills in order to start the Lupron whenever I wanted to. We're going to the beach the second week of September, and there's no way in hell I want to be dealing with either a period or Lupron shots while I'm on vacation. I intend to be blind drunk the entire time. So, at this point I'm thinking we may be ready to start the Lupron around the 3rd week of September. We'll see. I guess it depends on how long it takes us to figure out the financial part of the equation.

Sooooo, I'm still obviously very disappointed that we're not currently pregnant. But, thanks to the upbringing of my two wonderful parents I'm a fairly resilient person. I think I'm over the bulk of rage and bitterness that swept over me for most of last week. It's not the end of the world, for pete's sake. It's just another failed cycle. It sucks, but we'll try again, that's all. The way I figure - if no one is dying, then it's a pretty good goddamn day. Losing a parent to cancer has a way of helping to put life's trials into perspective. This is hard. Really hard. But R and I are still here, still putting one foot in front of the other, still loving and laughing and enjoying each other and dreaming of the future. I keep trying to focus on my innumerable blessings, and that really seems to help.

Negative

As expected. Still didn't make the news any easier to hear.

I feel like an empty shell. Metaphorically, emotionally, physically.....My heart feels permanently broken. But I know it isn't.

And in spite of being just SO fucking sick and tired of all of this shit, all I really want to focus on is trying again. I don't want to hear - oh you should just take some time and grieve and think and reflect, blah, blah, blah. No, I'm all out of patience. I'm all done with taking breaks and wasting precious time. I'll be 37 in 3 months. I want to start another cycle now. Today. This very instant! That's the only thing that would make me feel any better. Plowing ahead.

So you can imagine how I wanted to leap through the phone and strangle the receptionist when she told me in a semi-snotty tone that the earliest I could get in to see Dr. G to talk about what went wrong and what we can do next is August 31. There's no WAY I'm waiting an entire month. I emailed my nurse and begged her to cram me into Dr. G's schedule anywhere she could. I would meet him in the parking lot, call him on his cell phone while he's sitting in beltway traffic, meet him at 6am,9pm, the middle of the flippin' night, whatever it takes, just get me an appointment sooner than a month away!

I thought I had prepared myself and all I would feel today is more anger, more bitterness. Interestingly, I mostly feel sad and sorry for myself right now. Not angry, so much. More pitifully disappointed. I bet more of the lovely rage I've been experiencing will be back tomorrow though.

I also don't feel like "talking this out" with any of my best friends like I usually do. The only person I want to talk to is R, and he won't be home from work for another couple of hours.

What is there to say anyway? This sucks. That about sums it up.